Your Digest for Thursday, Apr 18, 2024 03:59 PM


    - Can also be viral (HSV, EBV, adenovirus) etc 

chlamydiaTrachomatisInfection.jpg

Mnemonic: Can't Have Good Sex on a Tricycle

[!TIP] Mnemonic: Gardner's don't harm the garden -> G.vaginalis doesn't cause inflammation
Therefore, clear discharge. (but fishy smell)

comparisonVaginalDischarges.png

  1. Friedrich's ataxia (but this does not show anticipation since it is an #autosomal-Recessive disease and disease is usually not seen in > 1 generation) Source

CMV infection (cytomegalovirus)


MitochondrialInheritanceTree.png

A family history in which males and females are affected, affected females transmit the disease to ⭐ALL their children, and affected males do not transmit the disease to their children suggests mitochondrial inheritance
Mitochondria produce energy. Mitochondrial disease are diseases which arise because of defects in the respiratory chain as 13 respiratory proteins are encoded by mitrochondrial DNA.


MucosalLeishmaniasis.png


Refsum disease - previousyl hereditary sensory motor neuropathy IV.
RefsumMnemonic.png


parinaudSyndrome.png

Tay Sach's disease


Pathology of cancers

Dysplasia:


Chronic granulomatous disease


Anaplastic CA grows rapidly. Many patients present with local invasion (unresectable tumours) or cervial lymph node metastasis.

Vessel injury of any cause produces the same stereotyped response. Intimal thickening is a stereotypical response to vessel injury.
Mechanism: Intimal injury stimulates migration of smooth muscle cells from the media OR from circulating precursors!. They arrive in the intima, undergo mitosis and produces extracellular matrix, forming a 'neointima'. This is analogous to scar formation elsewhere. Neointimal smooth muscle cells are non contractile but can undergo mitosis and have greater synthetic capacity. This altered activation of neointimal smooth muscle cells is driven by cytokines produced by platelets, macrophages, endothelial cells and circulating complement and coagulation factors. Cytokines involved are PDGF, FGF, TGF-alpha (Platelet derived growth factors, Fibroblast growth factors, TGF-alpha).

  1. **Endothelial dysfunction** is promoted mainly by altered haemodynamics and hypercholesterolemia.
  2. **Dysfunctional endothelium** promotes adhesion of inflmmatory cells including macrophages (which *engulf LDL* to become foam cells)  and T lymphocytes (which set up chronic inflammation). 

The majority of plaque ruptures occurs in the proximal and middle of coronary arteries and distal ruptures are rare.

Immunoglobulin / antibody classes

Antibody class Function
IgG Main serum antibody; Opsonization and complement activation. Production is stimulated by Interferron-gamma produced by TH1 cells.
IgM Predominant antibody during primary immune response. Can neutralize pathogens but not as well as IgG (which has higher affinity). But more potent activator of complement. Unlike IgG, IgM cannot readily enter tissues. Source
IgA Neutralizes microbes in GI and respiratory tracts. (i.e Mucosal associated antibody)
IgE IgE coats helminthic parasites and functions with mast
cells and eosinophils to kill them. Production is stimulated by cytokines from TH2 cells.

The primary humoral immune response to a novel pathogen typically requires close to a week before substantial amounts of IgM appear in the blood, and the innate immune response is necessary to fight the infection until the creation of T cells and antibody-secreting plasma cells clonally expanded against the pathogen in sufficient numbers. Source

Neutrophil defects

neutrophilChemotaxisAndDefects.png
> Is with recurrent and severe bacterial (Staphylococcus, pseudomonas, salmonella, Nocardia) and fungal (candida, Aspergillus) infections, most commonly of the respiratory tract and skin.

Inherited neutorphil defects

  1. [[2022 May Basic Sciences#Chronic granulomatous disease|Chronic Granulomatous disease]] <- a defect in neutrophil killing. (defect in ROS production)
  2. Hyper IgE syndrome - Job's syndrome
  3. Schwachman-Diamond syndrome ^226faf
  4. Chediak-Higashi syndrome

Acquired neutrophil defects / neutropenia


Therefore,⭐ POEMS is a paraproteinaemic neuropathy.
P - ⭐demyelinating polyneuropathy.
POEMSSyndromeSkinFeatures.png

A) Hyperpigmentation. (B) Hypertrichosis. (C) A typical hemangioma. (D) Hemangiomas with darkened mammary areola. (E) White nails. (F) Acrocyanosis. (G) Dry skin and ichthyosis-like lesions
Source